A new Department of Health and Human Services report charges that hospitals pushed unnecessary gender transitions on vulnerable children because they saw dollar signs.
At times the behavior crossed the line into fraud, the report says, with children’s hospitals and pediatric gender clinics misusing billing codes to make insurance companies pay for treatments that might otherwise have been rejected as wrong or unnecessary.
With the report in hand, Health and Human Services Secretary Robert F. Kennedy Jr. referred more than 200 medical entities to the HHS inspector general for a more thorough investigation into wrongdoing.
Vice President J.D. Vance, meanwhile, has asked the Department of Justice to investigate.
“More than just pushing these procedures on kids, hospitals and providers may have been defrauding Medicaid and private insurers by using misleading or fraudulent billing codes to get insurance to cover the costs,” said Mr. Vance, who heads the White House’s anti-fraud task force.
The moves are part of a broad escalation in the Trump administration’s efforts to try to re-cork the bottle on gender transitions involving juveniles.
Days before the report, Mr. Kennedy finalized a policy blocking federal Medicaid and Children’s Health Insurance Program money from being used to pay for “sex-rejecting procedures” — surgery or medication — for children.
The regulation is slated to take effect Oct. 13, though it allows a phaseout of some hormone treatments.
The HHS report, titled “Wolves in White Coats,” says that “financial incentives” helped promote the explosion of kids announcing gender transitions and getting medical treatments. Once children start treatment, they become “captive patients,” needing continuous care extending into adulthood, the report says.
Researchers identified nearly $120 million billed for “sex-rejecting procedures” since 2019, including tens of millions of dollars that went to puberty blockers but were billed as unspecified endocrine disorders.
“The medical establishment and the government failed innocent children. This report exposes how these calculated financial and political efforts left children irreversibly harmed and abandoned at the very moments when they needed real support,” the report concludes.
The Human Rights Campaign, a leading LGBTQ group, denounced the report as rehashed and repackaged complaints.
“We can’t lose sight of the fact that this obsessive and meritless campaign against transition care for youth is causing real harm — real people, families and their children, are suffering at the hands of their own government,” said HRC President Kelley Robinson. “It’s barbaric, it’s appalling, and it’s a disgrace.”
While pinning blame on hospitals and clinics, the Health and Human Services report says the Biden administration acted as an enabler. That includes expanding Obamacare’s nondiscrimination policy to cover gender identity, then engaging in a lengthy — and ultimately losing — battle to defend that in court.
The Department of Health and Human Services under Mr. Biden also explicitly endorsed the use of “early gender-affirming care,” including puberty-blocking drugs, which it said were reversible, and hormone therapy, which it labeled as “partially reversible.” It said surgery, typically for adults though available “case-by-case” for adolescents, was not reversible.
The HHS report details cases of people who detransitioned. A common theme among them is children who faced abuse or other undiagnosed mental health conditions but, because they also struggled with identity, were rushed into transition procedures. They said doctors treated their transitions as a settled matter and no alternatives treatments were offered.
The Trump administration has been pursuing medical facilities that promote gender transitions with a series of subpoenas. They have met with resistance in lower courts; however, the Justice Department won an important ruling late last week when the 9th U.S. Circuit Court of Appeals overturned one of those lower court blockades.
In a 2-1 decision, the appeals court said the feds had a valid purpose in issuing a subpoena to QueerDoc. The majority rejected the conclusion of U.S. District Judge Jamal Whitehead, a Biden appointee, who said the government was trying to “intimidate” the firm, which specializes in telemedicine for transgender individuals.
U.S. District Judge Carlos Bea, a George W. Bush appointee, said Judge Whitehead was wrong to tie political advocacy statements from other administration officials to the Justice Department’s issuance of the subpoena.
But in Massachusetts, a federal district ruled that states can include gender transition treatments as part of their definition of “essential care” under Obamacare.
Outside of the courts, the Justice Department has worked with individual hospitals on agreements to stop administering puberty blockers and cross-sex hormones to juveniles.
Deals with the Cleveland Clinic and Texas Children’s Hospital were announced earlier this year, in conjunction with state authorities.
The Texas settlement included a $10 million fine for billing the state’s Medicaid program for “illegal ‘gender-transition’ interventions,” including use of false diagnosis codes. The hospital agreed to fire five employees involved in the matter and to establish a “detransition clinic.”
Cleveland Clinic’s agreement included a settlement payment of $308,000 to resolve false billing allegations.
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